Individual provider Active NPI

Karen Molison Decker, LCSW-R

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1063563005
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R059858-1 Issued in NY
Practice address
3 Gates Cir
8TH Floor
Buffalo, NY 14209-1120
Phone
(716) 887-5789
Fax
(716) 887-5801
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R059858-1 NY Primary

Addresses

Primary practice location

3 Gates Cir
8TH Floor
Buffalo, NY 14209-1120

Mailing address

3 Gates Cir
8TH Floor
Buffalo, NY 14209-1120
Phone (716) 887-5789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140929000322 NY Practitioner - Clinical Social Worker 3870713720 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R059858-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Jan 1, 2014 Accepting new patients
Kaleida Health CurrentSince Jan 1, 2014 Accepting new patients
University at Buffalo Pathologists, Inc Current Accepting new patients
Kaleida Health Current Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063563005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GATES CIR",
            "address_2": "8TH FLOOR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142091120",
            "telephone_number": "716-887-5789",
            "fax_number": "716-887-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GATES CIR",
            "address_2": "8TH FLOOR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142091120",
            "telephone_number": "716-887-5789",
            "fax_number": "716-887-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "KAREN",
        "middle_name": "MOLISON",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R059858-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.